Rural vs urban inequalities in stage at diagnosis for lung cancer

Bashir Daud Shah; Chung-Chun Tyan; Masud Rana; Donna Goodridge; Christopher A Hergott; Nathaniel D Osgood; Braden Manns; Erika D Penz

doi:10.1016/j.ctarc.2021.100495

Rural vs urban inequalities in stage at diagnosis for lung cancer

Cancer Treat Res Commun. 2021:29:100495. doi: 10.1016/j.ctarc.2021.100495. Epub 2021 Nov 26.

Authors

Bashir Daud Shah¹, Chung-Chun Tyan², Masud Rana³, Donna Goodridge², Christopher A Hergott⁴, Nathaniel D Osgood⁵, Braden Manns⁶, Erika D Penz⁷

Affiliations

¹ College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
² Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada; Respiratory Research Centre, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
³ Collaborative Program in Biostatistics, University of Saskatchewan, Saskatoon, Saskatchewan , Canada.
⁴ Section of Respiratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
⁵ Department of Computer Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
⁶ Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Departments of Medicine and Community Health Sciences, Libin Cardiovascular Institute and O'Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada.
⁷ Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada; Respiratory Research Centre, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: erika.penz@usask.ca.

PMID: 34875463
DOI: 10.1016/j.ctarc.2021.100495

Abstract

Objectives: Early diagnosis of lung cancer increases the chance of survival. The aim of this study was to measure the relationship between geographic residence in Saskatchewan and stage of lung cancer at the time of diagnosis.

Materials and methods: Retrospective cohort analysis of 2,972 patients with a primary diagnosis of either non-small cell cancer (NSCLC) or small cell lung cancer (SCLC) between 2007 and 2012 was performed. Incidence proportion of early and advanced stage cancer, and relative risk of being diagnosed with advanced-stage lung cancer relative to early-stage was calculated.

Results: Compared to urban Saskatchewan, rural Saskatchewan lung cancer patients had a higher relative risk of advanced stage NSCLC (relative risk [RR] = 1.11, 95% confidence interval [CI]: 1.01-1.22). Rural Saskatchewan was further subdivided into north and south. The relative risk of advanced stage NSCLC in rural north Saskatchewan compared to urban Saskatchewan was even greater (RR = 1.17, 95% CI: 1.03-1.31). Although not statistically significant, there was a trend for a higher incidence of advanced stage SCLC in rural and rural north vs urban Saskatchewan (RR = 1.16, 95% CI: 0.95-1.43 and RR = 1.22; 95% CI: 0.94-1.58, respectively). There was a higher incidence proportion of advanced stage NSCLC in rural areas relative to urban (31.6-34.4 vs 29.5 per 10,000 people).

Conclusion: Patients living in rural Saskatchewan have higher incidence proportion of and were more likely to present with advanced stage NSCLC in comparison to urban Saskatchewan patients at time of diagnosis. This inequality was even greater in rural north Saskatchewan.

Keywords: Diagnosis; Lung cancer; Rural; Saskatchewan; Stage; Urban.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Female
Humans
Lung Neoplasms / epidemiology*
Lung Neoplasms / mortality
Male
Neoplasm Staging
Rural Population
Survival Analysis
Urban Population